Prognostic factors in early-stage lung adenocarcinoma: a multicenter study prognostic markers in early lung adenocarcinoma

Lung adenocarcinoma is the most common subtype of non-small cell lung cancer (NSCLC) and has shown increasing incidence worldwide. Although early-stage lung adenocarcinoma generally has a better prognosis, recurrence occurs in 30–50% of cases. Surgical resection remains the gold standard treatment for early-stage disease. Identifying prognostic factors is essential for guiding postoperative follow-up and determining the need for adjuvant therapy. We retrospectively evaluated 1,057 patients who underwent surgery for early-stage lung adenocarcinoma between 2007 and 2020 at two thoracic surgery centers. Descriptive statistics, including means and standard deviations, were calculated for continuous variables. Survival analysis was performed using Kaplan–Meier estimates, and prognostic factors were assessed through Cox proportional hazards regression. The mean age was 61.2 ± 9.0 years (range: 23–87), with 284 females (26.9%) and 773 males (73.1%). Female patients demonstrated significantly better survival (p < 0.001). Poor survival outcomes were associated with pathological N1 involvement, as well as lymphatic, perineural, vascular, and pleural invasion (p ≤ 0.008 for all). Multivariate analysis identified male sex (p < 0.001, HR: 1.53) as a poor prognostic factor, and perineural invasion (p = 0.005, HR: 0.71), and absence of vascular invasion (p = 0.047, HR: 0.80) as independent predictors of good prognosis. Male sex, perineural invasion, and vascular invasion were found to be independent poor prognostic factors in early-stage lung adenocarcinoma. Patients with these features should be monitored more closely and considered for adjuvant treatment strategies.